Obesity prevalence pre and post-pandemic. An analysis in 3 factsheets

08 March 2023
It is impossible to ignore the impact the Covid-19 pandemic has had on all aspects of our lives over the last few years. Many of these impacts are ongoing and remain a concern for many. Of course, it was expected that the pandemic would have a profound effect on population health, including on rates of overweight and obesity. So, what does the data tell us the impact of the pandemic has been on the prevalence of overweight and obesity in Scotland?

We’ve recently published three factsheets reporting on obesity prevalence in Scotland between 2019 and 2022 to paint a picture of obesity prevalence for adults and children pre and post-pandemic. The factsheets are not designed to be a trend analysis but rather to shine a spotlight on obesity prevalence at each point in time and to highlight the impact of pandemic on weight outcomes.  

The latest pre-pandemic year (2019) saw a continued upward trajectory of overweight and obesity prevalence, with two-thirds of adults living with overweight and obesity, and 30% of children aged 2 to 15 at risk of overweight and obesity1. For children in primary 1 (those aged around 5) one in ten were at risk of obesity2. Fast forward one year to 2020, and the data presents a mixed picture. Whilst self-reported prevalence of adult overweight and obesity fell to 62%3, the proportion of primary 1 age children at risk of obesity rose sharply to 15.5% (the highest on record)4. Across both years, there is a clear and persistent pattern of inequality among primary 1 age children with regards to obesity prevalence, with those in the most deprived areas more than twice as likely to be at risk of obesity than their least deprived peers1,4.

However, the 2020 data needs to be interpreted with caution. The pandemic also significantly impacted data collection. Both surveys used in the prevalence factsheets – the Scottish Health Survey (SHeS) and Body Mass Index of Primary 1 Children in Scotland – suffered changes to their usual methodologies, sample sizes, and a significant reduction in the number of questions asked. The SHeS was particularly impacted – the survey changed from an in-person survey to being conducted over the telephone with self-reported height and weight measurements replacing measured data, and many questions were simply not asked. Children’s weight data and adult overweight and obesity data by deprivation quintile for example weren’t collected in 2020. As such, the SHeS report states that the data from the 2020 survey cannot be compared to previous years or used in trend analysis3. The Primary 1 BMI data was less severely impacted, due to the survey spanning academic rather than calendar years. The 2020/21 survey had a significantly reduced sample size but the survey report outlines that data is sufficiently comparable with previous years, to be able to provide and be used for meaningful trend analysis and year-to-year comparison4.

Where does this complicated data picture leave us today?

The latest data from 2021 shows that rates of overweight and obesity in adults are higher than ever before, with more than two-thirds of adults (67%) living with overweight and obesity5. For children in primary 1 in academic year 2021/22, 11.7% were at risk of obesity6. Whilst this is a drop from the previous year, obesity risk remains higher for primary 1 age children than it did in pre-pandemic in 2019/20. Inequality also continues to persist, with children in the most deprived areas more than twice as likely to be at risk of obesity than those in the least deprived areas6.

Given the methodology changes and the unique nature of 2020 for data gathering, we would expect to see fluctuation in rates of obesity prevalence across a range of measures and this has certainly been the case. In 2021, methodologies and data collection practices returned to be much more like those of 2019, and if we compare pre and post pandemic (2019/20 and 2021/22), we can see a clear pattern of a growing prevalence of obesity in both adults and children in Scotland. This rising obesity prevalence and persistent inequality has been exacerbated by the pandemic. Such patterns were clearly visible before the pandemic and continue to be worsening.

The Covid-19 pandemic shown a light on the need for a healthy population, and whilst the worst of the immediate impact from the pandemic may be over, it has a left a lasting health impact, with rates of adult and childhood obesity in Scotland higher now than at any point pre-pandemic. The data presented in our latest factsheets point a spotlight on the continually rising obesity prevalence in Scotland, and the persistent inequality between the most and least deprived in our society. It underlines the need for national level prevention-focused public health policies to improve the food environment to reverse this increase in obesity prevalence.

Our recently published suite of three obesity prevalence factsheets can be read and downloaded here.

 

References

1. Scottish Government (2020) Scottish Health Survey 2019 – volume 1: main report https://www.gov.scot/publications/scottish-health-survey-2019-volume-1-main-report/

2. Public Health Scotland (2020) Body Mass Index of Primary 1 Children in Scotland. School Year 2019/20  https://publichealthscotland.scot/media/6546/2020-12-15-p1-bmi-statitstics-publication-report.pdf

3. Scottish Government (2021) Scottish Health Survey 2020 edition – telephone survey – volume 1: main report https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2021/01/scottish-health-survey-telephone-survey-august-september-2020-main-report/documents/scottish-health-survey-2020-edition-telephone-survey-volume-1-main-report/scottish-health-survey-2020-edition-telephone-survey-volume-1-main-report/govscot%3Adocument/scottish-health-survey-2020-edition-telephone-survey-volume-1-main-report.pdf

4. Public Health Scotland (2021) Body Mass Index of Primary 1 Children in Scotland. School Year 2020/21 https://www.publichealthscotland.scot/media/10829/2021-12-14-p1-bmi-statistics-publication-report.pdf

5. Scottish Government (2022) Scottish Health Survey 2021 – volume 1: main report https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2022/11/scottish-health-survey-2021-volume-1-main-report/documents/scottish-health-survey-2021-volume-1-main-report/scottish-health-survey-2021-volume-1-main-report/govscot%3Adocument/scottish-health-survey-2021-volume-1-main-report.pdf 

6. Public Health Scotland (2022) Body Mass Index of Primary 1 Children in Scotland. School Year 2021/22 https://publichealthscotland.scot/media/16960/2022-12-13-p1-bmi-statistics-publication-report.pdf